ArticleJAMA health forum2022
Development and Assessment of a New Framework for Disease Surveillance, Prediction, and Risk Adjustment: The Diagnostic Items Classification System.
Article in JAMA health forum, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 21 citations in OpenAlex.
- Cross-sectional analysis of accuracy versus interpretability in Medicare Advantage risk adjustment.Health policy OPEN · 2026Article
- A real-world evaluation of longitudinal healthcare expenses in a health system registry of type-2 diabetes mellitus and cardiovascular disease enabled by the 21st century cures act.American journal of preventive cardiology · 2026Article
- A framework for ex-ante evaluation of the potential effects of risk equalization and risk sharing in health insurance markets with regulated competition.Health economics review · 2024Review
- A Novel Machine Learning Algorithm for Creating Risk-Adjusted Payment Formulas.JAMA health forum · 2024Article
- Comparison of diagnosis-based risk adjustment methods for episode-based costs to apply in efficiency measurement.BMC health services research · 2023Article
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: Current disease risk-adjustment formulas in the US rely on diagnostic classification frameworks that predate the Objective: To develop an Design Setting and Participants: Physician teams mapped all Main Outcomes and Measures: Fourteen concurrent outcomes were predicted: overall and plan-paid health care spending (top-coded and not top-coded); enrollee out-of-pocket spending; hospital days and admissions; emergency department visits; and spending for 6 types of services. The primary outcome was annual health care spending top-coded at $250 000. Results: A total of 65 901 460 person-years were split into 90% estimation/10% validation samples (n = 6 604 259). In all, 3223 DXIs were created: 2435 main effects, 772 modifiers, and 16 scaled items. Stepwise regressions predicting annual health care spending (mean [SD], $5821 [$17 653]) selected 76% of the main effect DXIs with no evidence of overfitting. Validated Conclusions: In this diagnostic modeling study, the new DXI classification system showed improved predictions over existing diagnostic classification systems for all spending and utilization outcomes considered.
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